Technical evaluation of a third generation optical pose tracker for motion analysis and image-guided surgery

Laparoscopic instrument tracking systems are an essential component in image-guided interventions and offer new possibilities to improve and automate objective assessment methods of surgical skills. In this study we present our system design to apply a third generation optical pose tracker (Micron- Tracker®) to laparoscopic practice. A technical evaluation of this design is performed in order to analyze its accuracy in computing the laparoscopic instrument tip position. Results show a stable fluctuation error over the entire analyzed workspace. The relative position errors are 1.776±1.675 mm, 1.817±1.762 mm, 1.854±1.740 mm, 2.455±2.164 mm, 2.545±2.496 mm, 2.764±2.342 mm, 2.512±2.493 mm for distances of 50, 100, 150, 200, 250, 300, and 350 mm, respectively. The accumulated distance error increases with the measured distance. The instrument inclination covered by the system is high, from 90 to 7.5 degrees. The system reports a low positional accuracy for the instrument tip.

Comparative study of two laparoscopic instrument tracker designs for motion analysis and image-guided surgery: a technical evaluation

Laparoscopic instrument tracking systems are a key element in image-guided interventions, which requires high accuracy to be used in a real surgical scenario. In addition, these systems are a suitable option for objective assessment of laparoscopic technical skills based on instrument motion analysis. This study presents a new approach that improves the accuracy of a previously presented system, which applies an optical pose tracking system to laparoscopic practice. A design enhancement of the artificial markers placed on the laparoscopic instrument as well as an improvement of the calibration process are presented as a means to achieve more accurate results. A technical evaluation has been performed in order to compare the accuracy between the previous design and the new approach. Results show a remarkable improvement in the fluctuation error throughout the measurement platform. Moreover, the accumulated distance error and the inclination error have been improved. The tilt range covered by the system is the same for both approaches, from 90º to 7.5º. The relative position error is better for the new approach mainly at close distances to the camera system

Upper Limb Portable Motion Analysis System Based on Inertial Technology for Neurorehabilitation Purposes

Here an inertial sensor-based monitoring system for measuring and analyzing upper limb movements is presented. The final goal is the integration of this motion-tracking device within a portable rehabilitation system for brain injury patients. A set of four inertial sensors mounted on a special garment worn by the patient provides the quaternions representing the patient upper limb’s orientation in space. A kinematic model is built to estimate 3D upper limb motion for accurate therapeutic evaluation. The human upper limb is represented as a kinematic chain of rigid bodies with three joints and six degrees of freedom. Validation of the system has been performed by co-registration of movements with a commercial optoelectronic tracking system. Successful results are shown that exhibit a high correlation among signals provided by both devices and obtained at the Institut Guttmann Neurorehabilitation Hospital.

Correlation study between motion analysis of laparoscopic instruments and a suturing checklist

Purpose: To compare assessment capabilities of a motion analysis tool against a validated checklist during laparoscopic training.

Supervised classification of minimally invasive surgery psychomotor competence based on instruments motion analysis

Background Objective assessment of psychomotor skills has become an important challenge in the training of minimally invasive surgical (MIS) techniques. Currently, no gold standard defining surgical competence exists for classifying residents according to their surgical skills. Supervised classification has been proposed as a means for objectively establishing competence thresholds in psychomotor skills evaluation. This report presents a study comparing three classification methods for establishing their validity in a set of tasks for basic skills’ assessment. Methods Linear discriminant analysis (LDA), support vector machines (SVM), and adaptive neuro-fuzzy inference systems (ANFIS) were used. A total of 42 participants, divided into an experienced group (4 expert surgeons and 14 residents with >10 laparoscopic surgeries performed) and a nonexperienced group (16 students and 8 residents with <10 laparoscopic surgeries performed), performed three box trainer tasks validated for assessment of MIS psychomotor skills. Instrument movements were captured using the TrEndo tracking system, and nine motion analysis parameters (MAPs) were analyzed. The performance of the classifiers was measured by leave-one-out cross-validation using the scores obtained by the participants. Results The mean accuracy performances of the classifiers were 71 % (LDA), 78.2 % (SVM), and 71.7 % (ANFIS). No statistically significant differences in the performance were identified between the classifiers. Conclusions The three proposed classifiers showed good performance in the discrimination of skills, especially when information from all MAPs and tasks combined were considered. A correlation between the surgeons’ previous experience and their execution of the tasks could be ascertained from results. However, misclassifications across all the classifiers could imply the existence of other factors influencing psychomotor competence.

Time-motion analysis on Chinese male field hockey players

The aim of the study was to evaluate the match work-rate of Chinese field hockey players by analyzing the distance covered at different intensities pooled by specific positions during different periods of matches. Thirty-eight players from twenty-four male field hockey matches at the 11th Chinese National Games were filmed and analyzed.

Time-motion analysis on Chinese male field hockey players

The aim of the study was to evaluate the match work-rate of Chinese field hockey players by analyzing the distance covered at different intensities pooled by specific positions during different periods of matches. Thirty-eight players from twenty-four male field hockey matches at the 11th Chinese National Games were filmed and analyzed.mas

Segmentación de Secuencias de Vídeo: análisis y desarrollo de estrategias para la detección de cambios de toma y para la detección de objetos móviles

The important technological advances experienced along the last years have resulted in an important demand for new and efficient computer vision applications. On the one hand, the increasing use of video editing software has given rise to a necessity for faster and more efficient editing tools that, in a first step, perform a temporal segmentation in shots. On the other hand, the number of electronic devices with integrated cameras has grown enormously. These devices require new, fast, and efficient computer vision applications that include moving object detection strategies. In this dissertation, we propose a temporal segmentation strategy and several moving object detection strategies, which are suitable for the last generation of computer vision applications requiring both low computational cost and high quality results. First, a novel real-time high-quality shot detection strategy is proposed. While abrupt transitions are detected through a very fast pixel-based analysis, gradual transitions are obtained from an efficient edge-based analysis. Both analyses are reinforced with a motion analysis that allows to detect and discard false detections. This analysis is carried out exclusively over a reduced amount of candidate transitions, thus maintaining the computational requirements. On the other hand, a moving object detection strategy, which is based on the popular Mixture of Gaussians method, is proposed. This strategy, taking into account the recent history of each image pixel, adapts dynamically the amount of Gaussians that are required to model its variations. As a result, we improve significantly the computational efficiency with respect to other similar methods and, additionally, we reduce the influence of the used parameters in the results. Alternatively, in order to improve the quality of the results in complex scenarios containing dynamic backgrounds, we propose different non-parametric based moving object detection strategies that model both background and foreground. To obtain high quality results regardless of the characteristics of the analyzed sequence we dynamically estimate the most adequate bandwidth matrices for the kernels that are used in the background and foreground modeling. Moreover, the application of a particle filter allows to update the spatial information and provides a priori knowledge about the areas to analyze in the following images, enabling an important reduction in the computational requirements and improving the segmentation results. Additionally, we propose the use of an innovative combination of chromaticity and gradients that allows to reduce the influence of shadows and reflects in the detections.

Análisis de imágenes basado en correlación de imágenes

El objetivo principal del proyecto es la realización de una aplicación en el programa MATLAB. En primer lugar, realizaremos un estudio teórico relativo al tema de nuestro proyecto. En nuestro caso como el tema es Imagen y Televisión, explicaremos de forma teórica la información principal acerca del Tratamiento Digital de la Imagen. Una vez conocida las técnicas principales utilizadas en el tratamiento digital, realizaremos un estudio exhaustivo en las técnicas actuales que existen acerca del análisis de imágenes. Daremos una breve explicación mostrando en qué consiste esta técnica, los diferentes pasos que se llevan a cabo en una imagen para su análisis, explicando brevemente cada unos de ellos y enumerando algunas técnicas para la realización de cada una de ellas. Tras esta primera parte, nos centraremos en las técnicas de correlación de imágenes (DIC). Explicaremos como han surgido estas técnicas, cual son sus principales conceptos, sus inicios y las ventajas e inconvenientes que tienen. Dentro de las diferentes técnicas de correlación de imágenes, explicaremos de forma detallada la correspondencia por áreas, ya que es la técnica que vamos a utilizar para la realización del proyecto. Explicaremos en qué consiste, y desarrollaremos teóricamente cual son los pasos que se deben realizar en las imágenes para realizar esta técnica. Explicaremos cual es su terminología, y cuáles son los posibles defectos que puede tener esta técnica. Finalmente, una vez estudiada la teoría, realizaremos una sencilla aplicación que nos permita evaluar y encontrar las diferencias en una secuencia de imágenes. El programa utilizado para este proyecto es MATLAB, que es un programa matemático, utilizado enormemente en el ámbito de la ingeniería. Mediante esta aplicación obtendremos dos figuras, una de ellas donde veremos los vectores de movimiento que existen entre las dos imágenes y la segunda, donde obtendremos el factor de correlación que hay entre las dos imágenes. ABSTRACT OF MY PROJECT The main objective of the project is the development of an application in MATLAB program. Firstly carry out a theoretical study on the topic of our project. In our case as the theme is Picture and Television, we explain the main information about Digital Image Processing. Once known the main techniques used in digital images, we will make a study on current techniques that exist about image analysis. We will give a brief explanation showing what this technique is, the different steps that are performed on an image for analysis, briefly explaining each of them and listing some techniques for performing each. After this first part, we will focus on the techniques of image correlation (DIC). We explain how these techniques have emerged, which are the main concepts, the beginning and the advantages and disadvantages they have. There are different image correlation techniques. We will explain in detail the correspondence areas, as it is the technique that we will use for the project. Explain what it is, which is theoretically and we develop steps that must be performed on the images for this technique. We explain what their terminology is, and what are the possible defects that may have this technique. Finally, having explored the theory images, we will make a simple application that allows us to evaluate and find differences in a sequence of images. The program used for this project is MATLAB, a mathematical program, widely used in the field of engineering. Using this application will get two figures, one where we will see the motion vectors between the two images and the second where we get the correlation factor between the two images.

Conceptual framework for the design, implementation and validation of psychomotor skills’ assessment systems in minimally invasive surgery

Las técnicas de cirugía de mínima invasión (CMI) se están consolidando hoy en día como alternativa a la cirugía tradicional, debido a sus numerosos beneficios para los pacientes. Este cambio de paradigma implica que los cirujanos deben aprender una serie de habilidades distintas de aquellas requeridas en cirugía abierta. El entrenamiento y evaluación de estas habilidades se ha convertido en una de las mayores preocupaciones en los programas de formación de cirujanos, debido en gran parte a la presión de una sociedad que exige cirujanos bien preparados y una reducción en el número de errores médicos. Por tanto, se está prestando especial atención a la definición de nuevos programas que permitan el entrenamiento y la evaluación de las habilidades psicomotoras en entornos seguros antes de que los nuevos cirujanos puedan operar sobre pacientes reales. Para tal fin, hospitales y centros de formación están gradualmente incorporando instalaciones de entrenamiento donde los residentes puedan practicar y aprender sin riesgos. Es cada vez más común que estos laboratorios dispongan de simuladores virtuales o simuladores físicos capaces de registrar los movimientos del instrumental de cada residente. Estos simuladores ofrecen una gran variedad de tareas de entrenamiento y evaluación, así como la posibilidad de obtener información objetiva de los ejercicios. Los diferentes estudios de validación llevados a cabo dan muestra de su utilidad; pese a todo, los niveles de evidencia presentados son en muchas ocasiones insuficientes. Lo que es más importante, no existe un consenso claro a la hora de definir qué métricas son más útiles para caracterizar la pericia quirúrgica. El objetivo de esta tesis doctoral es diseñar y validar un marco de trabajo conceptual para la definición y validación de entornos para la evaluación de habilidades en CMI, en base a un modelo en tres fases: pedagógica (tareas y métricas a emplear), tecnológica (tecnologías de adquisición de métricas) y analítica (interpretación de la competencia en base a las métricas). Para tal fin, se describe la implementación práctica de un entorno basado en (1) un sistema de seguimiento de instrumental fundamentado en el análisis del vídeo laparoscópico; y (2) la determinación de la pericia en base a métricas de movimiento del instrumental. Para la fase pedagógica se diseñó e implementó un conjunto de tareas para la evaluación de habilidades psicomotoras básicas, así como una serie de métricas de movimiento. La validación de construcción llevada a cabo sobre ellas mostró buenos resultados para tiempo, camino recorrido, profundidad, velocidad media, aceleración media, economía de área y economía de volumen. Adicionalmente, los resultados obtenidos en la validación de apariencia fueron en general positivos en todos los grupos considerados (noveles, residentes, expertos). Para la fase tecnológica, se introdujo el EVA Tracking System, una solución para el seguimiento del instrumental quirúrgico basado en el análisis del vídeo endoscópico. La precisión del sistema se evaluó a 16,33ppRMS para el seguimiento 2D de la herramienta en la imagen; y a 13mmRMS para el seguimiento espacial de la misma. La validación de construcción con una de las tareas de evaluación mostró buenos resultados para tiempo, camino recorrido, profundidad, velocidad media, aceleración media, economía de área y economía de volumen. La validación concurrente con el TrEndo® Tracking System por su parte presentó valores altos de correlación para 8 de las 9 métricas analizadas. Finalmente, para la fase analítica se comparó el comportamiento de tres clasificadores supervisados a la hora de determinar automáticamente la pericia quirúrgica en base a la información de movimiento del instrumental, basados en aproximaciones lineales (análisis lineal discriminante, LDA), no lineales (máquinas de soporte vectorial, SVM) y difusas (sistemas adaptativos de inferencia neurodifusa, ANFIS). Los resultados muestran que en media SVM presenta un comportamiento ligeramente superior: 78,2% frente a los 71% y 71,7% obtenidos por ANFIS y LDA respectivamente. Sin embargo las diferencias estadísticas medidas entre los tres no fueron demostradas significativas. En general, esta tesis doctoral corrobora las hipótesis de investigación postuladas relativas a la definición de sistemas de evaluación de habilidades para cirugía de mínima invasión, a la utilidad del análisis de vídeo como fuente de información y a la importancia de la información de movimiento de instrumental a la hora de caracterizar la pericia quirúrgica. Basándose en estos cimientos, se han de abrir nuevos campos de investigación que contribuyan a la definición de programas de formación estructurados y objetivos, que puedan garantizar la acreditación de cirujanos sobradamente preparados y promocionen la seguridad del paciente en el quirófano. Abstract Minimally invasive surgery (MIS) techniques have become a standard in many surgical sub-specialties, due to their many benefits for patients. However, this shift in paradigm implies that surgeons must acquire a complete different set of skills than those normally attributed to open surgery. Training and assessment of these skills has become a major concern in surgical learning programmes, especially considering the social demand for better-prepared professionals and for the decrease of medical errors. Therefore, much effort is being put in the definition of structured MIS learning programmes, where practice with real patients in the operating room (OR) can be delayed until the resident can attest for a minimum level of psychomotor competence. To this end, skills’ laboratory settings are being introduced in hospitals and training centres where residents may practice and be assessed on their psychomotor skills. Technological advances in the field of tracking technologies and virtual reality (VR) have enabled the creation of new learning systems such as VR simulators or enhanced box trainers. These systems offer a wide range of tasks, as well as the capability of registering objective data on the trainees’ performance. Validation studies give proof of their usefulness; however, levels of evidence reported are in many cases low. More importantly, there is still no clear consensus on topics such as the optimal metrics that must be used to assess competence, the validity of VR simulation, the portability of tracking technologies into real surgeries (for advanced assessment) or the degree to which the skills measured and obtained in laboratory environments transfer to the OR. The purpose of this PhD is to design and validate a conceptual framework for the definition and validation of MIS assessment environments based on a three-pillared model defining three main stages: pedagogical (tasks and metrics to employ), technological (metric acquisition technologies) and analytical (interpretation of competence based on metrics). To this end, a practical implementation of the framework is presented, focused on (1) a video-based tracking system and (2) the determination of surgical competence based on the laparoscopic instruments’ motionrelated data. The pedagogical stage’s results led to the design and implementation of a set of basic tasks for MIS psychomotor skills’ assessment, as well as the definition of motion analysis parameters (MAPs) to measure performance on said tasks. Validation yielded good construct results for parameters such as time, path length, depth, average speed, average acceleration, economy of area and economy of volume. Additionally, face validation results showed positive acceptance on behalf of the experts, residents and novices. For the technological stage the EVA Tracking System is introduced. EVA provides a solution for tracking laparoscopic instruments from the analysis of the monoscopic video image. Accuracy tests for the system are presented, which yielded an average RMSE of 16.33pp for 2D tracking of the instrument on the image and of 13mm for 3D spatial tracking. A validation experiment was conducted using one of the tasks and the most relevant MAPs. Construct validation showed significant differences for time, path length, depth, average speed, average acceleration, economy of area and economy of volume; especially between novices and residents/experts. More importantly, concurrent validation with the TrEndo® Tracking System presented high correlation values (>0.7) for 8 of the 9 MAPs proposed. Finally, the analytical stage allowed comparing the performance of three different supervised classification strategies in the determination of surgical competence based on motion-related information. The three classifiers were based on linear (linear discriminant analysis, LDA), non-linear (support vector machines, SVM) and fuzzy (adaptive neuro fuzzy inference systems, ANFIS) approaches. Results for SVM show slightly better performance than the other two classifiers: on average, accuracy for LDA, SVM and ANFIS was of 71.7%, 78.2% and 71% respectively. However, when confronted, no statistical significance was found between any of the three. Overall, this PhD corroborates the investigated research hypotheses regarding the definition of MIS assessment systems, the use of endoscopic video analysis as the main source of information and the relevance of motion analysis in the determination of surgical competence. New research fields in the training and assessment of MIS surgeons can be proposed based on these foundations, in order to contribute to the definition of structured and objective learning programmes that guarantee the accreditation of well-prepared professionals and the promotion of patient safety in the OR.

EVA: Endoscopic Video Analysis of the surgical scene for the assessment of MIS psychomotor skills

The present work covers the first validation efforts of the EVA Tracking System for the assessment of minimally invasive surgery (MIS) psychomotor skills. Instrument movements were recorded for 42 surgeons (4 expert, 22 residents, 16 novice medical students) and analyzed for a box trainer peg transfer task. Construct validation was established for 7/9 motion analysis parameters (MAPs). Concurrent validation was determined for 8/9 MAPs against the TrEndo Tracking System. Finally, automatic determination of surgical proficiency based on the MAPs was sought by 3 different approaches to supervised classification (LDA, SVM, ANFIS), with accuracy results of 61.9%, 83.3% and 80.9% respectively. Results not only reflect on the validation of EVA for skills? assessment, but also on the relevance of motion analysis of instruments in the determination of surgical competence.

Experimental and statistical investigation of canonical problems in sloshing

En hidrodinámica, el fenómeno de Sloshing se puede definir como el movimiento de la superficie libre de un fluido dentro de un contenedor sometido a fuerzas y perturbaciones externas. El fluido en cuestión experimenta violentos movimientos con importantes deformaciones de su superficie libre. La dinámica del fluido puede llegar a generar cargas hidrodinámicas considerables las cuales pueden afectar la integridad estructural y/o comprometer la estabilidad del vehículo que transporta dicho contenedor. El fenómeno de Sloshing ha sido extensivamente investigado matemática, numérica y experimentalmente, siendo el enfoque experimental el más usado debido a la complejidad del problema, para el cual los modelos matemáticos y de simulación son aun incapaces de predecir con suficiente rapidez y precisión las cargas debidas a dicho fenómeno. El flujo generado por el Sloshing usualmente se caracteriza por la presencia de un fluido multifase (gas-liquido) y turbulencia. Reducir al máximo posible la complejidad del fenómeno de Sloshing sin perder la esencia del problema es el principal reto de esta tesis doctoral, donde un trabajo experimental enfocado en casos canónicos de Sloshing es presentado y documentado con el objetivo de aumentar la comprensión de dicho fenómeno y por tanto intentar proveer información valiosa para validaciones de códigos numéricos. El fenómeno de Sloshing juega un papel importante en la industria del transporte marítimo de gas licuado (LNG). El mercado de LNG en los últimos años ha reportado un crecimiento hasta tres veces mayor al de los mercados de petróleo y gas convencionales. Ingenieros en laboratorios de investigación e ingenieros adscritos a la industria del LNG trabajan continuamente buscando soluciones económicas y seguras para contener, transferir y transportar grandes volúmenes de LNG. Los buques transportadores de LNG (LNGC) han pasado de ser unos pocos buques con capacidad de 75000 m3 hace unos treinta años, a una amplia flota con una capacidad de 140000 m3 actualmente. En creciente número, hoy día se construyen buques con capacidades que oscilan entre 175000 m3 y 250000 m3. Recientemente un nuevo concepto de buque LNG ha salido al mercado y se le conoce como FLNG. Un FLNG es un buque de gran valor añadido que solventa los problemas de extracción, licuefacción y almacenamiento del LNG, ya que cuenta con equipos de extracción y licuefacción a bordo, eliminando por tanto las tareas de transvase de las estaciones de licuefacción en tierra hacia los buques LNGC. EL LNG por tanto puede ser transferido directamente desde el FLNG hacia los buques LNGC en mar abierto. Niveles de llenado intermedios en combinación con oleaje durante las operaciones de trasvase inducen movimientos en los buques que generan por tanto el fenómeno de Sloshing dentro de los tanques de los FLNG y los LNGC. El trabajo de esta tesis doctoral lidia con algunos de los problemas del Sloshing desde un punto de vista experimental y estadístico, para ello una serie de tareas, descritas a continuación, se han llevado a cabo : 1. Un dispositivo experimental de Sloshing ha sido configurado. Dicho dispositivo ha permitido ensayar secciones rectangulares de tanques LNGC a escala con movimientos angulares de un grado de libertad. El dispositivo experimental ha sido instrumentado para realizar mediciones de movimiento, presiones, vibraciones y temperatura, así como la grabación de imágenes y videos. 2. Los impactos de olas generadas dentro de una sección rectangular de un LNGC sujeto a movimientos regulares forzados han sido estudiados mediante la caracterización del fenómeno desde un punto de vista estadístico enfocado en la repetitividad y la ergodicidad del problema. 3. El estudio de los impactos provocados por movimientos regulares ha sido extendido a un escenario más realístico mediante el uso de movimientos irregulares forzados. 4. El acoplamiento del Sloshing generado por el fluido en movimiento dentro del tanque LNGC y la disipación de la energía mecánica de un sistema no forzado de un grado de libertad (movimiento angular) sujeto a una excitación externa ha sido investigado. 5. En la última sección de esta tesis doctoral, la interacción entre el Sloshing generado dentro en una sección rectangular de un tanque LNGC sujeto a una excitación regular y un cuerpo elástico solidario al tanque ha sido estudiado. Dicho estudio corresponde a un problema de interacción fluido-estructura. Abstract In hydrodynamics, we refer to sloshing as the motion of liquids in containers subjected to external forces with large free-surface deformations. The liquid motion dynamics can generate loads which may affect the structural integrity of the container and the stability of the vehicle that carries such container. The prediction of these dynamic loads is a major challenge for engineers around the world working on the design of both the container and the vehicle. The sloshing phenomenon has been extensively investigated mathematically, numerically and experimentally. The latter has been the most fruitful so far, due to the complexity of the problem, for which the numerical and mathematical models are still incapable of accurately predicting the sloshing loads. The sloshing flows are usually characterised by the presence of multiphase interaction and turbulence. Reducing as much as possible the complexity of the sloshing problem without losing its essence is the main challenge of this phd thesis, where experimental work on selected canonical cases are presented and documented in order to better understand the phenomenon and to serve, in some cases, as an useful information for numerical validations. Liquid sloshing plays a key roll in the liquified natural gas (LNG) maritime transportation. The LNG market growth is more than three times the rated growth of the oil and traditional gas markets. Engineers working in research laboratories and companies are continuously looking for efficient and safe ways for containing, transferring and transporting the liquified gas. LNG carrying vessels (LNGC) have evolved from a few 75000 m3 vessels thirty years ago to a huge fleet of ships with a capacity of 140000 m3 nowadays and increasing number of 175000 m3 and 250000 m3 units. The concept of FLNG (Floating Liquified Natural Gas) has appeared recently. A FLNG unit is a high value-added vessel which can solve the problems of production, treatment, liquefaction and storage of the LNG because the vessel is equipped with a extraction and liquefaction facility. The LNG is transferred from the FLNG to the LNGC in open sea. The combination of partial fillings and wave induced motions may generate sloshing flows inside both the LNGC and the FLNG tanks. This work has dealt with sloshing problems from a experimental and statistical point of view. A series of tasks have been carried out: 1. A sloshing rig has been set up. It allows for testing tanks with one degree of freedom angular motion. The rig has been instrumented to measure motions, pressure and conduct video and image recording. 2. Regular motion impacts inside a rectangular section LNGC tank model have been studied, with forced motion tests, in order to characterise the phenomenon from a statistical point of view by assessing the repeatability and practical ergodicity of the problem. 3. The regular motion analysis has been extended to an irregular motion framework in order to reproduce more realistic scenarios. 4. The coupled motion of a single degree of freedom angular motion system excited by an external moment and affected by the fluid moment and the mechanical energy dissipation induced by sloshing inside the tank has been investigated. 5. The last task of the thesis has been to conduct an experimental investigation focused on the strong interaction between a sloshing flow in a rectangular section of a LNGC tank subjected to regular excitation and an elastic body clamped to the tank. It is thus a fluid structure interaction problem.

Luz industrial e imagen tecnificada: de Moholy Nagy al C.A.V.S. (Center for Advanced Visual Studies)

El desarrollo de la tecnología de la luz implicará la transformación de la vida social, cultural y económica. Tanto las consideraciones espaciales del Movimiento Moderno, como los efectos producidos por la segunda Guerra Mundial, tendrán efectos visibles en las nuevas configuraciones espaciales y en la relación simbiótica y recíproca que se dará entre ideología y tecnología. La transformación en la comprensión de la articulación espacial, asociada al desarrollo tecnológico, afectará al modo en que este espacio es experimentado y percibido. El espacio expositivo y el espacio escénico se convertirán en laboratorio práctico donde desarrollar y hacer comprensible todo el potencial ilusorio de la luz, la proyección y la imagen, como parámetros modificadores y dinamizadores del espacio arquitectónico. Esta experimentación espacial estará precedida por la investigación y creación conceptual en el mundo plástico, donde los nuevos medios mecánicos serán responsables de la construcción de una nueva mirada moderna mediatizada por los elementos técnicos. La experimentación óptica, a través de la fotografía, el cine, o el movimiento de la luz y su percepción, vinculada a nuevos modos de representación y comunicación, se convertirá en elemento fundamental en la configuración espacial. Este ámbito de experimentación se hará patente en la Escuela de la Bauhaus, de la mano de Gropius, Schlemmer o Moholy Nagy entre otros; tanto en reflexiones teóricas como en el desarrollo de proyectos expositivos, arquitectónicos o teatrales, que evolucionarán en base a la tecnología y la modificación de la relación con el espectador. El espacio expositivo y el espacio escénico se tomarán como oportunidad de investigación espacial y de análisis de los modos de percepción, convirtiéndose en lugares de experimentación básicos para el aprendizaje. El teatro se postula como punto de encuentro entre el arte y la técnica, cobrando especial importancia la intersección con otras disciplinas en la definición espacial. Las múltiples innovaciones técnicas ligadas a los nuevos fundamentos teatrales en la modificación de la relación con la escena, que se producen a principios del siglo XX, tendrán como consecuencia la transformación del espacio en un espacio dinámico, tanto física como perceptivamente, que dará lugar a nuevas concepciones espaciales, muchas de ellas utópicas. La luz, la proyección y la creación de ilusión en base a estímulos visuales y sonoros, aparecen como elementos proyectuales efímeros e inmateriales, que tendrán una gran incidencia en el espacio y su modo de ser experimentado. La implicación de la tecnología en el arte conllevará modificaciones en la visualización, así como en la configuración espacial de los espacios destinados a esta. Destacaremos como propuesta el Teatro Total de Walter Gropius, en cuyo desarrollo se recogen de algún modo las experiencias espaciales y las investigaciones desarrolladas sobre la estructura formal de la percepción realizadas por Moholy Nagy, además de los conceptos acerca del espacio escénico desarrollados en el taller de Teatro de la Bauhaus por Oskar Schlemmer. En el Teatro Total, Gropius incorporará su propia visión de cuestiones que pertenecen a la tradición de la arquitectura teatral y las innovaciones conceptuales que estaban teniendo lugar desde finales del s.XIX, tales como la participación activa del público o la superación entre escena y auditorio, estableciendo en el proyecto una nueva relación perceptual entre sala, espectáculo y espectador; aumentando la sensación de inmersión, a través del uso de la física, la óptica, y la acústica, creando una energía concéntrica capaz de extenderse en todas direcciones. El Teatro Total será uno de los primeros ejemplos en los que desde el punto de partida del proyecto, se conjuga la imagen como elemento comunicativo con la configuración espacial. Las nuevas configuraciones escénicas tendrán como premisa de desarrollo la capacidad de transformación tanto perceptiva, como física. En la segunda mitad del s.XX, la creación de centros de investigación como el CAVS (The Center for Advanced Visual Studies,1967), o el EAT (Experiments in Art and Technology, 1966), favorecerán la colaboración interdisciplinar entre arte y ciencia, implicando a empresas de carácter tecnológico, como Siemens, HP, IBM o Philips, facilitando soporte técnico y económico para el desarrollo de nuevos sistemas. Esta colaboración interdisciplinar dará lugar a una serie de intervenciones espaciales que tendrán su mayor visibilidad en algunas Exposiciones Universales. El resultado será, en la mayoría de los casos, la creación de espacios de carácter inmersivo, donde se establecerá una relación simbiótica entre espacio, imagen, sonido, y espectador. La colocación del espectador en el centro de la escena y la disposición dinámica de imagen y sonido, crearán una particular narrativa espacial no lineal, concebida para la experiencia. Desde las primeras proyecciones de cine a la pantalla múltiple de los Eames, las técnicas espaciales de difusión del sonido en Stockhausen, o los experimentos con el movimiento físico interactivo, la imagen, la luz en movimiento y el sonido, quedan inevitablemente convertidos en material arquitectónico. ABSTRACT. Light technology development would lead to a social, cultural and economic transformation. Both spatial consideration of “Modern Movement” and Second World War effects on technology, would have a visible aftereffect on spatial configuration and on the symbiotic and mutual relationship between ideology & technology. Comprehension adjustment on the articulation of space together with technology development, would impact on how space is perceived and felt. Exhibition space and scenic space would turn into a laboratory where developing and making comprehensive all illusory potential of light, projection and image. These new parameters would modify and revitalize the architectonic space. as modifying and revitalizing parameters of architectonic space. Spatial experimentation would be preceded by conceptual creation and investigation on the sculptural field, where new mechanic media would be responsible for a fresh and modern look influenced by technical elements. Optical experimentation, through photography, cinema or light movement and its perception, would turn into essential components for spatial arrangement linked to new ways of performance and communication. This experimentation sphere would be clear at The Bauhaus School, by the hand of Gropius, Schlemmer or Moholy Nag among others; in theoretical, theatrical or architectural performance’s projects, that would evolve based on technology and also based on the transformation of the relationship with the observer. Exhibition and perfor-mance areas would be taken as opportunities of spatial investigation and for the analysis of the different ways of perception, thus becoming key places for learning. Theater is postulated as a meeting point between art and technique, taking on a new significance at its intersection with other disciplines working with spatial definition too. The multiple innovation techniques linked to the new foundations for the theater regarding stage relation, would have as a consequence the regeneration of the space. Space would turn dynamic, both physically and perceptibly, bringing innovative spatial conceptions, many of them unrealistic. Light, projection and illusory creation based on sound and visual stimulus would appear as intangible and momentary design components, which would have a great impact on the space and on the way it is experienced. Implication of technology in art would bring changes on the observer as well as on the spatial configuration of the art spaces2. It would stand out as a proposal Walter Groupis Total Theater, whose development would include somehow the spatial experiments and studies about formal structure of perception accomplished by Moholy Nagy besides the concepts regarding stage space enhanced at the Bauhaus Theater Studio by Oskar Schlemmer. Within Total Theater, Groupis would incorporate his own view about traditional theatric architecture and conceptual innovations that were taking place since the end of the nineteenth century, such as active audience participation or the diffusing limits between scene and audience, establishing a new perception relationship between auditorium, performance and audience, improving the feeling of immersion through the use of physics, optics and acoustics, creating a concentric energy capable of spreading in all directions. Total Theater would be one of the first example in which, from the beginning of the Project, image is combined as a communicating element with the spatial configuration. As a premise of development, new stage arrangement would have the capacity of transformation, both perceptive and physically. During the second half or the twentieth century, the creation of investigation centers such as CAVS (Center for Advanced Visual Studies, 1967) or EAT (Experiments in Art and Technology, 1966), would help to the interdisciplinary collaboration between art and science, involving technology companies like Siemens, HP, IBM or Philips, providing technical and economic support to the development of new systems. This interdisciplinary collaboration would give room to a series of spatial interventions which would have visibility in some Universal Exhibitions. The result would be, in most cases, the creation of immersive character spaces, where a symbiotic relationship would be stablished between space, image, sound and audience. The new location of the audience in the middle of the display, together with the dynamic arrangement of sound and image would create a particular, no lineal narrative conceived to be experienced. Since the first cinema projections, the multiple screen of Eames, the spatial techniques for sound dissemination at Stockhausen or the interactive physical movement experimentation, image, motion light and sound would turn inevitably into architectural material.

Adaptive neuro-fuzzy inference systems (ANFIS) for supervised classification of competence in MIS based on psychomotor skills

INTRODUCTION: Objective assessment of motor skills has become an important challenge in minimally invasive surgery (MIS) training.Currently, there is no gold standard defining and determining the residents' surgical competence.To aid in the decision process, we analyze the validity of a supervised classifier to determine the degree of MIS competence based on assessment of psychomotor skills METHODOLOGY: The ANFIS is trained to classify performance in a box trainer peg transfer task performed by two groups (expert/non expert). There were 42 participants included in the study: the non-expert group consisted of 16 medical students and 8 residents (< 10 MIS procedures performed), whereas the expert group consisted of 14 residents (> 10 MIS procedures performed) and 4 experienced surgeons. Instrument movements were captured by means of the Endoscopic Video Analysis (EVA) tracking system. Nine motion analysis parameters (MAPs) were analyzed, including time, path length, depth, average speed, average acceleration, economy of area, economy of volume, idle time and motion smoothness. Data reduction was performed by means of principal component analysis, and then used to train the ANFIS net. Performance was measured by leave one out cross validation. RESULTS: The ANFIS presented an accuracy of 80.95%, where 13 experts and 21 non-experts were correctly classified. Total root mean square error was 0.88, while the area under the classifiers' ROC curve (AUC) was measured at 0.81. DISCUSSION: We have shown the usefulness of ANFIS for classification of MIS competence in a simple box trainer exercise. The main advantage of using ANFIS resides in its continuous output, which allows fine discrimination of surgical competence. There are, however, challenges that must be taken into account when considering use of ANFIS (e.g. training time, architecture modeling). Despite this, we have shown discriminative power of ANFIS for a low-difficulty box trainer task, regardless of the individual significances between MAPs. Future studies are required to confirm the findings, inclusion of new tasks, conditions and sample population.

Systems and technologies for objective evaluation of technical skills in laparoscopic surgery

Minimally invasive surgery is a highly demanding surgical approach regarding technical requirements for the surgeon, who must be trained in order to perform a safe surgical intervention. Traditional surgical education in minimally invasive surgery is commonly based on subjective criteria to quantify and evaluate surgical abilities, which could be potentially unsafe for the patient. Authors, surgeons and associations are increasingly demanding the development of more objective assessment tools that can accredit surgeons as technically competent. This paper describes the state of the art in objective assessment methods of surgical skills. It gives an overview on assessment systems based on structured checklists and rating scales, surgical simulators, and instrument motion analysis. As a future work, an objective and automatic assessment method of surgical skills should be standardized as a means towards proficiency-based curricula for training in laparoscopic surgery and its certification.